NPIMap

Organization Active NPI

Premier Internal Medicine LLC

  • Internal Medicine Physician
  • Columbus, OH
National Provider Identifier
1790069698
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PREMIER INTERNAL MEDICINE LLC
Practice address
6275 E Broad St
Columbus, OH 43213-1504
Phone
(614) 824-3394
NPI assigned
Oct 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Srinivas Anand Rao Ponneri
Title
Office Manager/Director RCM
Phone
(614) 373-4202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

6275 E Broad St
Columbus, OH 43213-1504

Mailing address

6275 E Broad St
Columbus, OH 43213-1504
Phone (614) 861-0967

National Provider Directory

National Provider Directory

Locations

6200 E Broad St
Columbus, OH 43213

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1790069698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6275 E BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131504",
            "telephone_number": "614-861-0967",
            "fax_number": "614-861-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6275 E BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131504",
            "telephone_number": "614-824-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-11",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A",
        "authorized_official_last_name": "PONNERI",
        "authorized_official_first_name": "SRINIVAS ANAND RAO",
        "authorized_official_title_or_position": "OFFICE MANAGER/DIRECTOR RCM",
        "authorized_official_telephone_number": "614-373-4202"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.